After two marketplace open enrollment periods, Ohio has experienced relatively low enrollment compared to other states and its post-subsidy premiums are among the highest of states that opted to have the federal government run their exchange.

The brief explores reasons for these dynamics and offers a menu of policy considerations to address the issues.

The report is part of a series of 25 state and regional studies commissioned by the ACA Implementation Research Network examining the rollout of the ACA over the past 5 years. The national Research Network -- with 36 states and 61 researchers -- is led by the Rockefeller Institute of Government, the public policy research arm of the State University of New York, the Brookings Institution, and the Fels Institute of Government at the University of Pennsylvania.